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Pathology of Disease: Describe the pathology related to your patients medical diagnosis. Include textbook signs and symptoms
Congestive heart failure is the inability of the heart to circulate blood effectively enough to meet the bodys metabolic needs. Heart failure
may affect the left or right ventricle, though often it affects the left side first. It may result from impaired ejection of blood from the heart
during systole or from impaired relaxation of the heart during diastole. About 400,000 people in the United States are diagnosed each year
with heart failure, and 10% to 20% die of the disease annually. The prognosis for patients with heart failure depends on the ejection
fraction, that is, the proportion of blood in the ventricle that is propelled from the heart during each contraction. Congestive heart failure
may result from myocardial infarction, myocardial ischemia, arrhythmias, heart valve lesions, congenital malformation of heart or vessels,
constrictive pericarditis, cardiomyopathies, renal failure, and fluid overload, thyrotoxicosis, and severe anemia. Congestive heart failure is
a chronic, long term condition that gradually becomes worse over time. The disease is easily diagnosed with a chest x-ray, which shows an
enlarged heart and pulmonary edema, and elevated levels (>100) of brain natriuretic peptide (BNP). Early symptoms include: labored
breathing, orthopnea, nocturia, and exertional fatigue. Later stage symptoms include: fatigue, pitting edema, dyspnea, ascites, below
normal O2 saturation, confusion, anxiety, crackles, wheeze, cough w/frothy pink or white sputum, enlarged spleen and liver, decreased
urine output, jugular vein distention (JVD), dilated pupils, cyanosis, cool skin, weak pulse, and decreased blood pressure.
Nursing Care: Monitor clients blood Nursing Care: Monitor clients blood pressure and pulse, weigh client daily, administer
pressure, pulse rate, and administer prescribed medications, maintain healthy diet, help client with mobility and exercise.
prescribed medications, teach patient to
make healthier lifestyle choices such as:
quit smoking, exercise, stress reduction,
low-fat diet choices, low-cholesterol diet
choices, lower salt intake.
How does your client compare to what is considered usual medical/nursing interventions?
My client is being well cared for by the nursing home staff and physicians. Medications are administered daily; eats a well-balanced diet,
and is made as comfortable as possible. The clients blood pressure, pulse rate, and weight are not monitored as often as the medication
nursing indications indicate.